ALCOHOLISM AND SUBSTANCE RELATED DISORDERS:Poly Drug Use

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Abnormal Psychology PSY404

Lesson 36

ALCOHOLISM AND SUBSTANCE RELATED DISORDERS

Recap of Previous Lecture

Personality refers to enduring patterns of thinking and behavior that define the person and distinguish

him or her from other people. These enduring patterns are ways of expressing emotion as well as

patterns of thinking about ourselves and other people. When enduring patterns of behavior and

emotion bring the person into repeated conflict with others, and when they prevent the person from

maintaining close relationships with others, an individual's personality may be considered disordered.

The authors of DSM-IV-TR have organized ten specific forms of personality disorder into three

clusters on the basis of broadly defined characteristics.

Classification of Personality Disorders

1-Paranoid personality disorder

2-Schizoid personality disorder

3-Schizotypal personality disorder

4-Antisocial personality disorder

5-Borderline personality disorder

6-Histrionic personality disorder

7-Narcissistic personality disorder

8-Avoidant personality disorder

9-dependent personality disorder

10-Obsessivecompulsive personality disorder

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ALCOHOLISM AND SUBSTANCE RELATED DISORDERS

Examples

· We take aspirin to reduce headache.

· We take an antibiotic to fight an infection.

· We take tranquilizer to calm us after facing a trauma.

· We drink coffee or tea to get going in the morning.

· Smoke a cigarette to relax our nerves.

· We take valium to go to sleep.

There are many substances that are capable of harming the body or adversely affecting the behavior and

mood. The misuse of drugs has become one of the most disabling problems of the society.

Examples

· Sherlock Holmes fictional character who took drugs stimulants to alert him.

· Sportsmen take drugs to enhance their performance but in the long run their body develops drug

dependence.

The term drug applies to any substance other than food that changes our bodily and mental functioning.

Drug misuse may lead to a temporary mental syndrome such as intoxication but chronic excessive use of

drugs can lead to a substance use disorder.

Substance use disorder can take two forms

1- Substance abuse

2- Substance dependence

1- Substance Abuse

A pattern in which people rely heavily on a drug and they structure their lives around the drug.

2- Substance Dependence

In which people show all symptoms of substance abuse plus physical dependence on the drug.

Drug Addiction

· Drug addiction is in which people show all symptoms of substance abuse plus physical dependence

on the drug.

· But now we use the term substance dependence and not addiction.

Drug Tolerance

· People who need increased doses of drug in order to get its effect.

· Withdrawal symptoms emerge when individual suddenly stops taking drugs or reduces their

dosage.

· These symptoms include muscle aches, pains and cramps, vomiting, nausea.

It is believed that approximately 7 % of all adults in United States currently display some form of

substance use disorder.

Poly Drug Use

When an individual uses two or more drugs at the same time we label it as poly drug use.

Cross Tolerance

· When people take more than one drug at a time and the drugs interact with each other. Some time

the two drugs display cross tolerance

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Cross tolerance is that the drugs act similarly on the brain and taking one drug will affect person's

tolerance for the other.

Synergistic Effect

When different drugs enhance each other's effect, they have a combined impact known as a synergistic

effect.

The drugs that we will focus in this chapter fall into three categories

1- Depressants are substances which slow the activity of central nervous system they include.

The important depressants are

· Alcohol

· Sedative-Hypnotic drugs

· Opioids

2- Stimulants are substances that increase the activity of the central nervous system, resulting in the

increased blood pressure, heart rate, intensified activity, thought processes and alertness.

The important stimulants are

· Cocaine

· Amphetamines

· Nicotine

· Caffeine

3- Hallucinogens are substances that cause changes primarily in sensory perception. They include

· LSD

· Cannabis drugs

The explanation for drug abuse can be done by using four perspectives

1- Biological

2- Psychodynamic

3- Behavioral

4- Socio-cultural

The biological view or perspective suggests that people inherit a predisposition to drug addiction based on

their research of twin and adoptee studies.

The psycho dynamic perspective view that people who turn to drugs have an inordinate dependency needs

and they turn to drugs.

Behavioral perspective suggests that drug use is reinforced because it reduces tension and raises spirits.

Socio-cultural perspective suggests that the people most likely to develop a pattern of drug abuse are those

where societies create stress and their families tolerate drug abuse.

Treatment for Substance Abuse Disorders

Treatment for substance abuse disorders include

1- Insight therapy

2- Aversive therapy

3- Behavioral self control training

4- Relapse prevention training

5- Self help groups

6- Therapeutic communities

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The goals of treatment for substance use disorders are a matter of controversy. Some clinicians believe

that the only acceptable goal is total absence from drinking or drug use. Others have argued that, for

some people, a more reasonable goal is the moderate use of legal drugs.

Detoxification

· Alcoholism and related forms of drug abuse are chronic conditions.

· Treatment is typically accomplished in a sequence of stages, beginning with a brief period of

detoxification--the removal of a drug on which a person has become dependent--for 3 to 6

weeks.

Medications

· Following the process of detoxification, treatment efforts are aimed at helping the person maintain

a state of remission.

· Several forms of medication are used to help the person refrain from drinking.

Self-Help Groups: Alcoholics Anonymous

· Alcoholics Anonymous (AA) is maintained by alcohol abusers for the sole purpose of helping other

people who abuse alcohol become and remain sober.

· AA is not officially associated with any other form of treatment or professional organization.

· The viewpoint espoused by AA is fundamentally spiritual in nature.

· DSM-IV-TR uses two terms to describe substance use disorders, and these terms reflect different

levels of severity.

Substance Dependence, the more severe of the two forms, refers to a pattern of repeated self-

administration that often results in tolerance, the need for increased amounts of the drug to achieve

intoxication; withdrawal, unpleasant physical and psychological effects that the person experiences

when he or she tries to stop taking the drug; and compulsive drug-taking behavior.

Substance Abuse describes a more broadly conceived, less severe pattern of drug use that is defined in

terms of interference with the person's ability to fulfill major role obligations at work or at home, the

recurrent use of a drug in dangerous situations, and repeated legal difficulties associated with drug use.

Addiction is another, older term that is often used to describe problems such as alcoholism.

The term has been replaced in official terminology by the term substance dependence, with which it is

synonymous, but it is still used informally by many lay people.

A drug of abuse, sometimes called a psychoactive substance, is a chemical substance that alters a

person's mood, level of perception, or brain functioning.

People with a substance use disorder frequently abuse several types of drugs; this condition is known as

poly-substance abuse.

Alcohol

· Alcohol affects virtually every organ and system in the body.

· After alcohol has been ingested, it is absorbed through membranes in the stomach, small intestine,

and colon.

· The rate at which it is absorbed is influenced by many variables, including the concentration of

alcohol in the beverage, the volume and rate of consumption, and the presence of food in the

digestive system.

· After it is absorbed, alcohol is distributed to all the body's organ systems.

· Almost all the alcohol that a person consumes is eventually broken down or metabolized in the

liver.

· If the person's consumption rate exceeds this metabolic limit, then blood alcohol levels will rise.

· Blood alcohol levels are measured in terms of the amount of alcohol per unit of blood.

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According to DSM-IV-TR, the symptoms of alcohol intoxication include slurred speech, lack of

coordination, an unsteady gait, nystagmus (involuntary to-and-fro movement of the eyeballs

induced when the person looks upward or to the side), impaired attention or memory, and stupor

or coma.

The prolonged use and abuse of alcohol can have a devastating impact on many areas of a person's

life.

1-The disruption of relationships with family and friends can be especially painful.

2-Regular heavy use of alcohol is also likely to interfere with job performance.

3-Many heavy drinkers encounter problems with legal authorities.

On a biological level, prolonged exposure to high levels of alcohol can disrupt the functions of

several important organ systems, especially the liver, pancreas, gastrointestinal system,

cardiovascular system, and endocrine system.

In fact, over an extended period of time, alcohol dependence has more negative health

consequences than abuse of any other drug, with the exception of nicotine. The misuse of alcohol

leads to an enormous number of severe injuries and premature deaths in every region of the world.

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